Improved medical care on Guam, finally having comprehensive patients’ rights and a fair process to bring cases of alleged medical negligence to a resolution while protecting doctors and patients is what Bill 112-36 aims to do. Bill 112-36 was introduced by Speaker Therese Terlaje and Sen. Telo Taitague with 10 supporting senators.
Bill 112 is a massive overhaul of the antiquated Medical Malpractice Mandatory Arbitration Act that is currently in place that protects doctors when they kill or injure their patients through medical negligence and then have no accountability.
Let’s look at the reasons that doctors are against Bill 112, as outlined by Dr. Ramel Carlos, in his recent letter to the editor at The Guam Daily Post (published April 24).
Carlos starts by rambling about the doctor’s Hippocratic oath and how doctors uphold the highest of moral standards and principles respecting medical ethics. I am not sure what his point is, but as he stated, “It’s also about doing no harm to a patient.” That is great, but when doctors break the oath by hurting or killing a patient thru negligence or even inappropriate sexual conduct, shouldn’t there be consequences? If not, what’s the use of this oath?
Carlos stated that doctors think that they are portrayed as elite members of society with deep pockets. I do not think this, but Dr. Carlos’ Letter to the Editor does seem elitist and apathetic to the suffering of patients and their families. The responses to his letter from the people on Guam speak volumes as to how his apparent apathy is viewed.
Eighty-five percent of Guam doctors do not have personal malpractice insurance. This is a direct benefit of the current law for doctors, as they know no one can afford arbitration, so why have malpractice insurance like every doctor in the country has. So, Dr. Carlos, maybe doctors do not have deep pockets as you mentioned, but they do benefit from the current law financially.
Carlos supports the current MMMAA, he clearly stated, a law which allows doctors to walk away after hurting or killing Guam’s loved ones. He benefits from it, but patients suffer from it. Why, Dr. Carlos, are you or your colleagues against a middle-of-the-road solution with Bill 112?
Carlos stated magistrates will not understand medical issues. Does the Guam Board of Medical Examiners understand medical issues, as they have never found in favor for any patient complaint under its current leadership out of 30 cases? Can that be true as some say it’s a cover-up? The magistrate has expert medical information in front of him or her. They will be fairer than the Guam Board of Medical Examiners or the MMMAA.
You favor the current law, but do you know arbitration can cost $50,000 to $100,000 or more? I think you are out of touch to think that any family on Guam can afford this, except maybe the deep pockets you referenced and it’s a form of punishment for anyone who dares challenge a physician.
Carlos stated Bill 112 is “truly creating a threatening climate, a dark cloud over those of us practicing medicine.” My gosh, you have heard patient consumers for 18 months asking for relief and have ignored their cries for reforming the MMMAA. Nearly every person on Guam has a story related to substandard medical care allegations. Why haven’t you tried to work out a good plan, which Bill 112 is? Why have you just sat there, with minions from the medical community pressuring senators to not protect the public, but just to keep the current law to protect themselves?
Please read the comments on Facebook under your Letter to the Editor to see how the community feels. Do you know that 1% of doctors commit 32% of malpractice? With the MMMAA, those negligent doctors are not identified, and they go off and do it potentially again. How many must die or be injured before you wake up? Actually, some of the doctors licensed by the Guam Board of Medical Examiners have histories of substandard or negligent behavior, then come to Guam and do the same thing. Are you aware of this?
Carlos pushes the idea of more lawsuits on Guam if patients are protected. Bill 112 is very well written so that should not happen, but if patients are not protected by Bill 112, we can expect more loss of life through medical negligence.
Dr. Carlos, you stated that you are worried about your (or your colleagues') financial situation and emotional health with a lawsuit. Bill 112 protects you, but should we as the people of Guam negate the death and injuries of our loved ones so you do not suffer? Should we concern ourselves with your issues or the loss of our loved ones as we lose people often to negligence and will continue to do so?
According to a national study, medical negligence is the third largest killer of Americans behind cancer and heart disease with an estimated 10 people per month on Guam dying from medical negligence. Is this medical calamity not worth addressing or is it about you or your colleagues not sleeping or getting sick or being held accountable?
We of course have to hear the threats from Carlos and other doctors, like kids who are not accountable and can do whatever they want. Carlos stated, “I am aware of physicians planning to leave the island if this bill goes into law.” This threat is nonsense and childish. Where will the doctors who leave Guam go? Is there a cheaper place with lower malpractice rates? Based on national averages, Guam doctors are also paid pretty darn good. I sat in three legislative information hearings about the MMMAA and at least 10 doctors were asked by the senators, "Will you leave if the law is changed?" All said no. I have asked my own doctor friends and personal doctors the same question and all said they won't leave. Dr. Carlos, will you leave? The doctors who will leave may be those with medical negligence backgrounds already as the GBME do license such off-island doctors who have come to Guam and did the same thing, including one being sought by the judicial system.
The biggest threat that doctors throw out at us, is as Carlos stated, “Recruiting will be impacted, and it certainly will be harder to recruit and retain physicians and other health care providers on Guam.” Dr. Carlos, how do you know this? Please provide references. Are you saying doctors come here now because Guam will license anyone and those doctors who cannot work in other places can work on Guam? We will not be able to recruit doctors if they have histories of negligence possibly. Do we want them? Ask the Guam Board of Medical Examiners how many they have licensed with histories of medical negligence or accusations of substandard medical care or sexual misconduct. Yes, they may not come to Guam to hurt us if Bill 112 is passed.
Dr. Carlos, personally, this statement that you said is an insult to the people of Guam. You stated, “the proposed new law will create an environment where defensive medicine is the norm. Physicians will feel obliged and compelled to perform more diagnostic testing.” So what, if defensive medicine saves lives, why are you against it? My son and hundreds of others may still be alive if defensive medicine was the norm or even basic medicine. It's an insult to the people of Guam to imply that doing extra tests are not needed. What’s wrong with you people? Save a life, do the extra tests or any tests in some cases. Shame on you. This statement alone shows why we need reform in the MMMAA. Lack of defensive and accountable medicine leads to apathy which is a major ingredient of medical negligence.
Why are you so afraid of Bill 112? Not once in your letter did you address patient rights or care or physician responsibility of any kind.
Guam has great doctors, but what we do not know is why some great doctors cover for negligent doctors. That is how we got to this point and why Bill 112 should be passed. It meets everyone’s needs except for those who think they are above accountability.